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Orientador(es)
Resumo(s)
Introdução: A hipertensão arterial é considerada a principal responsável pela carga global
de doença a nível mundial e afeta cerca de 4,06 mil milhões de indivíduos, contribuindo em
grande parte para a morbimortalidade cardiovascular. Concomitantemente, assiste-se a um
agravamento à escala global, do défice de vitamina D, que afeta uma percentagem
considerável da população. A identificação de vários intervenientes do metabolismo e
mecanismo de ação da vitamina D em sistemas que estão envolvidos na regulação da
pressão arterial, tem levantado a hipótese de que esta possa ter um papel na patogénese da
hipertensão arterial.
Objetivos: Investigar a associação entre a deficiência de vitamina D e o risco de
desenvolvimento de hipertensão arterial, bem como determinar se a suplementação de
vitamina D poderá ser útil no controlo da pressão arterial, sistematizando os principais
achados neste domínio através de uma revisão sistemática da literatura.
Metodologia: Foi realizada uma pesquisa bibliográfica com recurso à PubMed para
identificação de estudos coorte e ensaios clínicos randomizados potencialmente relevantes,
publicados entre 01 de janeiro de 2000 e 30 de novembro de 2020.
Resultados: Foram incluídos 35 artigos científicos (13 estudos coorte e 22 ensaios clínicos
randomizados) que cumpriam os critérios de inclusão definidos. Da análise destes estudos,
observa-se uma ligeira tendência que favorece o desenvolvimento de hipertensão em
indivíduos com défice de vitamina D, bem como uma inconsistência nos efeitos na pressão
arterial após suplementação de vitamina D, que parece ser mais benéfica em doentes
hipertensos.
Conclusão: Embora se tenha verificado a nível molecular, um potencial anti-hipertensor
da vitamina D, os achados dos estudos observacionais e intervencionais contemplados nesta
dissertação, não permitem atribuir com certeza um papel protetor da vitamina D no
desenvolvimento de hipertensão arterial. Cerca de metade dos estudos coorte não considera
que o défice de vitamina D seja um fator preditor de doença. A grande maioria dos ensaios
clínicos randomizados não suporta a hipótese de que a suplementação de vitamina D possa
contribuir para o controlo da pressão arterial na população geral. Assim sendo, ainda não
há evidência concreta que justifique a sua utilização de forma generalizada como estratégia
anti-hipertensiva.
Introduction: Hypertension has become the leading risk factor for disease burden at a global level and affects about 4,06 billion individuals, contributing largely to cardiovascular morbidity and mortality. Concomitantly, there is a global worsening of vitamin D deficiency, affecting a considerable percentage of the population. The identification of several intermediaries related to vitamin’s D mechanism of action in systems involved in blood pressure regulation has raised the hypothesis that it may have a role in the pathogenesis of hypertension. Objectives: To investigate the link between vitamin D deficiency and the risk of developing hypertension as well as to determine whether vitamin D supplementation may be useful in blood pressure control, summarizing the main findings in this field through a systematic literature review. Methodology: A literature search was conducted using PubMed to identify potentially relevant cohort studies and randomized clinical trials published between January 1, 2000 and November 30, 2020. Results: Thirty-five scientific articles (thirteen cohort studies and twenty-two randomized clinical trials) that met the defined inclusion criteria were included. The analysis of these studies revealed a slight trend favoring the development of hypertension in individuals with vitamin D deficiency, as well as an inconsistency in the effects on blood pressure after vitamin D supplementation, which seems to be more effective in hypertensive patients. Conclusion: Although a potential antihypertensive effect of vitamin D has been observed at a molecular level, the findings of the observational and interventional studies included in this dissertation do not allow the acknowledgment of vitamin D as a protective factor in the development of hypertension. About half of the cohort studies do not consider vitamin D deficiency to be a predictor of disease. The vast majority of randomized clinical trials do not support the hypothesis that vitamin D supplementation can contribute to blood pressure control in the general population. Therefore, there is still no concrete evidence to justify its widespread use as an antihypertensive strategy.
Introduction: Hypertension has become the leading risk factor for disease burden at a global level and affects about 4,06 billion individuals, contributing largely to cardiovascular morbidity and mortality. Concomitantly, there is a global worsening of vitamin D deficiency, affecting a considerable percentage of the population. The identification of several intermediaries related to vitamin’s D mechanism of action in systems involved in blood pressure regulation has raised the hypothesis that it may have a role in the pathogenesis of hypertension. Objectives: To investigate the link between vitamin D deficiency and the risk of developing hypertension as well as to determine whether vitamin D supplementation may be useful in blood pressure control, summarizing the main findings in this field through a systematic literature review. Methodology: A literature search was conducted using PubMed to identify potentially relevant cohort studies and randomized clinical trials published between January 1, 2000 and November 30, 2020. Results: Thirty-five scientific articles (thirteen cohort studies and twenty-two randomized clinical trials) that met the defined inclusion criteria were included. The analysis of these studies revealed a slight trend favoring the development of hypertension in individuals with vitamin D deficiency, as well as an inconsistency in the effects on blood pressure after vitamin D supplementation, which seems to be more effective in hypertensive patients. Conclusion: Although a potential antihypertensive effect of vitamin D has been observed at a molecular level, the findings of the observational and interventional studies included in this dissertation do not allow the acknowledgment of vitamin D as a protective factor in the development of hypertension. About half of the cohort studies do not consider vitamin D deficiency to be a predictor of disease. The vast majority of randomized clinical trials do not support the hypothesis that vitamin D supplementation can contribute to blood pressure control in the general population. Therefore, there is still no concrete evidence to justify its widespread use as an antihypertensive strategy.
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Palavras-chave
Deficiência de Vitamina D Hipertensão Arterial